Decentralising atrial fibrillation screening to overcome socio-demographic inequalities in uptake in STROKESTOP II
| Autor: | Johan Engdahl, Katrin Kemp Gudmundsdottir, Ulf Strömberg, Emma Svennberg, Anders Holmén, Tove Fredriksson, Faris Al-Khalili |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Inequality Socio demographics media_common.quotation_subject Emigrants and Immigrants socioeconomic factors 030204 cardiovascular system & hematology Screening uptake 03 medical and health sciences 0302 clinical medicine Environmental health Atrial Fibrillation medicine Humans Mass Screening 030212 general & internal medicine Healthcare Disparities Screening study media_common Aged Sweden Health Equity business.industry Health Policy Public Health Environmental and Occupational Health Atrial fibrillation Bayes Theorem Original Articles medicine.disease Female business |
| Zdroj: | Journal of Medical Screening |
| ISSN: | 1475-5793 |
| Popis: | Objective In the first STROKESTOP atrial fibrillation screening study, participation was influenced by socio-demographic and geographic factors. To improve uptake in the second study, two screening sites were added, closer to low-income neighbourhoods which had very low participation in the first study. This paper aims to analyse the geographic and socio-demographic disparities in uptake in the second trial and compare the results with the first trial. Methods Inhabitants of the Stockholm region born in 1940 and 1941 were randomised 1:1 to be invited to screening or serve as controls. Medical history, blood samples and single-lead-ECG were collected. Invitee’s residential parish was used for geo-mapping analysis of the geographical disparities in participation, using hierarchical Bayes methods. Individual data for participants and non-participants were obtained for the socioeconomic variables: educational level, disposable income, immigrant and marital status. Results Higher participation was observed in those with higher education, high income, among non-immigrants and married individuals. Participation between the first and second studies improved significantly, where additional screening sites were introduced. These improvements were generally significant, in each population group according to socio-demographic characteristics. Conclusion Decentralisation of screening sites in an atrial fibrillation screening program yielded a significantly positive impact on screening uptake. Adding local screening sites in areas with low uptake had beneficial impact on participation across a wide spectrum of socio-demographic groups. Decentralised screening substantially increased the screening uptake in deprived areas. |
| Databáze: | OpenAIRE |
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